| NPI | 1093279184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WV 96255) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CA 17906) |
| Enumeration Date | 2019-01-23 |
| Last Update Date | 2024-10-26 |